- The Washington Times - Thursday, March 6, 2003

Ever since the president mentioned the broad outline of the Medicare reform/prescription drug plan in his State of the Union address, he had been under fire from Democrats and Republicans for failing to provide specific details. On Tuesday, Mr. Bush put forth a credible plan. Now, many many of the same critics are carping about the specifics of the Bush plan and pushing to add a stand-alone prescription-drug entitlement on top of an unreformed Medicare program.
The administration's proposal would spend $400 billion over the next decade on a new Medicare drug benefit. It would give seniors the option to remain in the existing Medicare program or take the federal money and join a private plan.
To be sure, we have reservations about the cost of the Bush plan, which would be the most far-reaching change in Medicare since the creation of the program in 1965 as part of LBJ's Great Society program. But Mr. Bush's proposal is the least expensive one out there right now. The critics' main complaint seems to be that the president isn't generous enough in spending money on a new entitlement program for well-off seniors.
In reality, Mr. Bush and Health and Human Services Secretary Tommy Thompson deserve credit for putting forward a serious proposal to use market forces to provide prescription drugs and reform Medicare a program in dire need of major change if it is to be there when 75 million baby-boomers retire.
There are currently 40 million Medicare recipients, a number which is expected to double by 2030. That's when the program's trust fund, which pays mostly for hospital care, will run out of money if Medicare is not dramatically restructured. According to the Congressional Budget Office, without transfers from general funds, Medicare will face a cumulative deficit of $5.8 trillion over the next 23 years. And all of this is without factoring in the cost of a new prescription drug benefit.
Many seniors, of course, would welcome such a program. While Medicare pays for a great range of services in doctors' offices and hospitals, it does not cover prescription drug costs. These medications provide a relatively inexpensive way of treating serious conditions like heart disease and Parkinson's, especially when compared with even a brief stay in the hospital (stays that can be reduced in time or unnecessary if patients have access to medications outside the hospital).
Unfortunately, the problem since the late 1990s has been getting Republicans and Democrats to agree on Medicare reform. The Clinton administration rejected a Republican proposal, and failed to propose its own reform plan. Last year, Mr. Bush and Senate Democrats reached a stalemate once again. Judging from the bipartisan negative reaction to the president's latest proposal, there's a real danger that Republicans in their haste to pass drug legislation this year will insist on passing a stand-alone prescription bill rather than real Medicare reform.
Passing such a reform bill would require maximum political effort for the White House. Between war, the postwar period, terrorism, North Korea, tax relief and the ever-draining appropriations battles, we wonder whether there will be sufficient White House energy and focus to make that massive effort this year. But, if the Bush White House is able to marshal that political energy, there is a chance.

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